BlueCard^® connection: Do I report Medicare supplemental claims differently for members enrolled outside of Michigan?

No. All claims, including Medicare supplemental claims, must be reported the same way you report claims for Blue Cross Blue Shield of Michigan members.

Most Medicare primary claims automatically transfer, or cross over, to a member’s home plan. That’s why you shouldn’t send a Medicare supplemental BlueCard claim to us for at least 30 days from the date of Medicare’s payment to you. Billing sooner can result in a front-end edit for electronic submitters or a payment delay or claim denial for paper submitters.

The following Blue Cross edits will be returned to electronic submitters on 277CAP transactions and R277CAH and R277CAI edit reports:

• P951 A3 516 SUPPLEMENTAL CLM RECD WITHIN 30 DAYS OF MEDICARE PROC DATE
• F716 A3 516 SUPPLEMENTAL CLM RECD WITHIN 30 DAYS OF MEDICARE PROC DATE

Here are some other things you need to know about BlueCard supplemental claims:

• Report all of the prior payer information exactly as it was returned to you on Medicare’s 835 electronic remittance or the Medicare paper voucher.
• Medicare supplemental claims for BlueCard members who have notified Medicare of their supplemental contract will cross over directly to the member’s Blue Cross plan. The home plan will pay you directly.

If you need assistance on a BlueCard Medicare crossover claim, contact Blue Cross Provider Inquiry. We’ll contact the out-of-area Blue Cross plan for you.

For more information about the BlueCard program, including links and articles on online tools, see the BlueCard chapter of the online provider manuals.

If you have questions about the information in the BlueCard chapter of the online manual or if you’d like more information on a particular topic, contact your provider consultant.

Want to suggest a topic to be covered in this series? Send an email to ProvComm@bcbsm.com with “BlueCard series” in the subject line.